Patient and family-centered care (PFCC) represents a new paradigm for health care delivery, where patients and their families take an active role in healthcare management and decisionmaking. Evidence shows that PFCC improves outcomes, including reduction of medication errors, increased compliance, and better disease management. Implementation of patient centered care in the ambulatory setting remains elusive for most US clinical practices. An electronic personal health record (ePHR) helps overcomes barriers to adoption of PFCC by maximizing patient-clinical collaboration, self management, and related health outcomes. The proposed project will examine the feasibility, acceptability, and impact of a health IT intervention (the ePHR) that has been modified using a patient- and family-centered approach and incorporates the experiences, perspectives, and insights of patients and family members actually using the system. We will compare patients using the ePHR intervention to a group of patients with "care as usual." Our Specific Aims are: (1) To improve the application of patient and family-centered care elements in an existing ePHR, based on feedback from a pilot study of patients and their families. The modified ePHR will be tested in a pilot group of patients with hypertension and their families. (2) To implement and test the effectiveness of the modified ePHR with patients being treated for hypertension by a team of physicians, mid-level practitioners, nurse clinicians, and support staff in two ambulatory settings. Outcome measures will include patient activation and perception of care, quantifiable biological markers, patient physician communication, and congruence of treatment with guidelines, particularly medication management. (3) To monitor the shift in provider and support staff awareness and incorporation of patient- and family-centered care as a result of implementation of the ePHR using questionnaires and focus groups. If successful, this ePHR could be implemented in additional locations in the Southeast.